Premium
Predictors of Chronic Kidney Disease in Long‐Term Survivors of Lung and Heart‐Lung Transplantation
Author(s) -
Canales M.,
Youssef P.,
Spong R.,
Ishani A.,
Savik K.,
Hertz M.,
Ibrahim H. N.
Publication year - 2006
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01458.x
Subject(s) - medicine , renal function , creatinine , kidney disease , transplantation , kidney transplantation , kidney , urology , lung transplantation , lung , surgery
Renal insufficiency is common after non‐renal organ transplants. The predictors of long‐term renal outcomes are not well established. A total of 219 lung and heart‐lung transplant recipients surviving more than 6 months after transplantation were studied to determine predictors of time to doubling of serum creatinine and end‐stage kidney disease (ESKD) with death as a competing risk. Median follow‐up was 79 months (range 9–222 months). Baseline estimated glomerular filtration rate (GFR) was 96.3 ± 34.5 mL/min/1.73 m 2 . One hundred twenty‐two recipients (55%) doubled their serum creatinine, 16 (7.3%) progressed to ESKD and 143 (65%) died. The majority of recipients who survived >6 years had a GFR < 60 mL/min at both 1 and 7 years. Most of the loss of renal function occurred in the first year post‐transplant. Older age at transplant, lower GFR at 1 month and cyclosporine use in the first 6 months predicted shorter time to doubling of serum creatinine when death was handled as a competing risk. Based on this prevalence data and using GFR decay and death as study endpoints, we offer sample size estimates for a prospective, interventional trial that is aimed at slowing or preventing the progression of kidney disease.